动态测定不同平面脑损伤后昏迷患者血浆胃液NT的含量变化

目的　测定不同平面脑损伤后昏迷患者血浆、胃液NT含量的动态变化 ,探讨其与脑损伤程度的关系及对胃肠动力的影响。方法　采用放免法动态测定 32例不同平面脑损伤后昏迷患者血浆、胃液NT含量 ,以观察NT水平在脑损伤后昏迷组和正常对照组中的变化。结果　不同平面脑损伤后昏迷患者血浆、胃液NT含量第 1～ 5天显著高于正常对照组 ,第10～ 2 0天逐渐下降 ,第 2 0～ 30天接近正常对照组水平 ,脑损伤后昏迷患者急性期死亡组与生存组 ,合并消化道出血组、呕吐组与未合并消化道症状组血浆、胃液NT含量均高于正常对照组 ,而组间比较呈梯次排列。不同平面脑损伤后昏迷患者急性期限血浆、胃液NT显著高于正常对照组水平 ,各组间有一定差异、组间比较以丘脑、基底节、皮层、脑干损伤组呈梯次分布。结论　损伤后昏迷患者存在NT分泌异常 ,NT参与了脑损伤后昏迷患者继发病理、生理过程。动态测定血浆、胃液NT含量有助于判断脑损伤程度、胃肠动力状况、估计预后并为临床治疗护理、建立良好的进食模式提供依据。

Dynamic changes of plasma and gastric NT in coma patients with brain trauma

Objective To determining the dynamic changes of plasma and gastric NT 1 in 32 coma patients with brain trauma and to explore the relationships between the changes and the brain trauma as well as the gastrointestinal motility.Method The radioimmunological method was applied to determining the changes of plasma and gastric NT in 32 com patients with brain trauma in different regions in order to compare the changes with those of controls.Results The levels of plasma and gastric NT in coma patients were significantly higher than those of controls in the first five days after brain trauma.Then they declined progressively from the 10th day to the 20th day and approximated to those of controls form the 21st to the 30th day.In the coma population,there existed statistically significant differences among the dead group,the survival group with gastric haemorrhage and vomtiting and the survival group without gastric sympotom as far as the plasma and gastric NT was concerned.As regarded the different brain regions with trauma,the highest levels were seen in the patients with trauma in thalamus,followed by basal ganglion,cotrex and brain stem in order.Conclusions The abnormal NT secretion usually occurring in coma patients with brain trauma which plays a very important role part in the secondary disease in the population physiologically.Dynamic record of the levels of plasma and gastric NT can help not only estimate brain trauma,the dynamic states of gastrointestinal motility and prognosis,but also contribute to decisions on the treatment,nursing and reasonable oral nutrition. [